摘要
原發性肺淋巴瘤是一種罕見的肺部疾病，其中最常見的組織學型態為分化良好的B細胞腫瘤併有低程度淋巴增生，可能來自支氣管相關的淋巴組織。我們報告一例以乾咳、體重減輕為最初表現的原發性肺淋巴瘤男性病患，其胸部X光檢查呈現左舌葉實質化，經支氣管鏡生檢的病理報告是淋巴球間質肺炎，開胸手術取得的組織切片用特殊染色證實這是一例B細胞淋巴瘤。經過一系列檢查後，未發現侵犯到骨髓、胃及其它器官的證據。這個病患接受三次化學藥物治療後，原先的症狀很顯著的改善。原發性肺淋巴瘤在診斷與治療方面仍有許多問題尚待進一步研究，不過和其他部位的非何杰金氏淋巴瘤比起來，預後沒有那麼差。
並列摘要
Primary pulmonary lymphoma is a rare lung disease. The most common histological subtype is the well-differentiated B-cell tumor with a low-grade lymphoproliferative process. This appears to arise from bronchus-associated lymphoid tissue (BALT). We report a patient with primary pulmonary lymphoma, with the presentation of nonproductive cough and body weight loss. The chest radiograph showed left lingular consolidation. Transbronchial biopsy revealed lymphocytic interstitial pneumonitis. Open lung biopsy with immuno-histochemistrical stains confirmed the diagnosis of a marginal zone B-cell lymphoma. There was no evidence of involvement of the bone marrow, stomach, or other organs. After 3 courses of chemotherapy with cyclophosphamide, vincristine and prednisolone (COP), the patient’s symptoms greatly improved. This primary lung lymphoma presented with diagnostic and therapeutic problems, but was not associated with a similar grave prognosis as found in non-Hodgkin’s lymphomas of other sites.
延伸閱讀
- Lin, H. J., Chiang, I. P., & Lin, C. T. (2002). 原發性結膜淋巴瘤－病例報告. 中華民國眼科醫學會雜誌, 41(3), 271-275. https://doi.org/10.30048/ACTASOS.200209.0009
- Yen, P. S., Wan, Y. L., Ng, S. H., Hung, C. F., Tsai, C. C., & Ho, Y. S. (1995). 肺淋巴管平滑肌瘤症：病例報告. 中華放射線醫學雜誌, 20(1), 89-93. https://www.airitilibrary.com/Article/Detail?DocID=10188940-199503-20-1-89-93-a
- Ou, C. C., Chao, T. Y., Lai, Y. F., Wong, S. L., & Huang, S. C. (2001). 原發性肺橫紋肌肉瘤：病例報告. 胸腔醫學, 16(2), 119-123. https://www.airitilibrary.com/Article/Detail?DocID=10239855-200106-16-2-119-123-a
- 王本欽、陳俊烈、陳志毅、王丕延、朱海榮、何霖（1988）。肺部淋巴管肌瘤症─病例報告。The Kaohsiung Journal of Medical Sciences，4(5)，311-315。https://doi.org/10.6452/KJMS.198805.0311
- Chen, H. H., Tsai, C. M., Perng, R. P., Chien, S. T., & Hsu, J. Y. (2008). 罕見的原發性肺部腫瘤：病例報告. 胸腔醫學, 23(1), 14-18. https://doi.org/10.29806/TM.200802.0003